Some see threat to 24/7 emergency mental-health care in Florida

TALLAHASSEE | The Florida Legislature is considering a plan that would change the way the state pays to treat people who need emergency mental health care, a move critics say would gut the current system to benefit large hospital systems.

Under the current system, the state Department of Children and Families contracts with 117 public and private Crisis Stabilization Units around the state , paying nearly $300 a day per bed regardless of whether they are occupied. The system, which cost the state $61.3 million last year, guarantees that the crisis units have enough beds and staff to meet peak needs, supporters say.

They say the arrangement allows for families and law enforcement to get treatment quickly for people who suffer mental breakdowns and keeps many of them out of jail, where they would get no treatment.

Crisis Stabilization Units have to treat patients regardless of whether they have insurance. Many of the patients are being held under the state’s Baker Act, which allows people who are suffering a mental breakdown and are a threat to themselves or others to be evaluated for up to 72 hours, even without their permission.

The new bill (SB 1726) would cut the guaranteed funding by 75 percent and any excess patients would be sent to private hospitals, which would be paid about $1,200 a day for every patient they treat. They would not be paid for unused beds.

At a recent hearing of the Senate Children, Families and Elder Affairs Committee, lawmakers from both parties spoke out against the proposal.

“This bill, I think, is three steps in the backward direction,” said Sen. Alan Hays, R-Umatilla, who suggested DCF should draw up a solution. He said the bill would impair the work that the current emergency clinics are performing.

His colleague, Sen. Charles Dean, R-Inverness, supports the proposed change, saying it may not be the best way to handle mental health crises, “but it’s the best way we have today.”

Among the potential winners under the proposed change would be University Behavioral Center in Orlando, which is part of a national chain of medical facilities, and whose CEO said the proposal is “budget neutral.”

But others warned of closures and fewer beds if the measure goes through.

“This impacts over 155,000 Floridians whose lives are at risk because they are so sick they’re a danger to self or others,” said Mary Ruiz, CEO of Manatee Glen, a mental health and addiction treatment center in Bradenton. “If Florida doesn’t pay for availability 24-seven for Baker Act services, will they be available in each community?”

An amendment to the bill approved late last week by the Senate Appropriations Committee would buy some time for the stakeholders, though, by requiring establishment of a database to see how many beds are being used and when. It would require daily and monthly reporting on Baker Act admissions “that will allow the Legislature to see how the money is being spent,” said Sen. Denise Grimsley, R-Sebring, sponsor of the amendment.